ATI Med Surge Proctored Exam | 2023/ 2024
Questions and Verified Answers| Update
Q: To monitor the progression of decreased urinary stream, the nurse should encourage which
type of regular screening?
Answer:
Digital rectal examination (DRE)
*DRE is part of a regular physical examination and is a primary means of assessing symptoms of
decreased urinary stream, which is often caused by benign prostatic hyperplasia (BPH) in men
older than 50 years of age. The uroflowmetry helps determine the extent of urethral blockage and
the type of treatment needed but is not done on a regular basis. Transrectal ultrasound is
indicated with an abnormal DRE and elevated PSA to differentiate between BPH and prostate
cancer. The PSA monitoring is done to rule out prostate cancer, although levels may be slightly
elevated in patients with BPH.
Q: The patient has a low-grade carcinoma on the left lateral aspect of the prostate gland and has
been on “watchful waiting” status for 5 years. Six months ago, his last prostate-specific antigen
(PSA) level was 5 ng/mL. Which manifestations indicate prostate cancer may be extending and
require a change in the plan of care (select all that apply.)?
Answer:
Serum PSA level 10 ng/mL
Nodularity of the prostate gland
Q: A 71-yr-old patient with a diagnosis of benign prostatic hyperplasia (BPH) has been
scheduled for a contact laser technique. What is the primary goal of this intervention?
Answer:
Resumption of normal urinary drainage
*The most significant signs and symptoms of BPH relate to the disruption of normal urinary
drainage and consequent urine retention, incontinence, and pain. A laser technique vaporizes
prostate tissue and cauterizes blood vessels and is used as an effective alternative to a TURP to
resolve these problems. Fluid imbalances, impaired sexual functioning, and kidney disease may
result from uncontrolled BPH, but the central focus remains urinary drainage.
Q: A nurse is caring for a patient with a history of chronic obstructive pulmonary disease
(COPD) admitted for pneumonia. What laboratory finding would be consistent with decreased
kidney function in this patient?
Answer:
Serum creatinine 2.3 of mg/dL
Q: A patient was admitted 2 weeks ago after multiple traumatic injuries in a motor vehicle
collision. The patient now has a serum creatinine at 3.9 mg/dL and blood urea nitrogen (BUN) of
100 mg/dL. Which medication, if ordered by the health care provider, should the nurse question?
Answer:
Gentamicin
*Elevated serum creatinine and BUN indicate renal insufficiency or acute kidney injury.
Medications (e.g., prescribed, over-the-counter, and herbs) should be evaluated for nephrotoxic
potential. Many drugs are known to be nephrotoxic (see Table 44-3); gentamicin is a potential
nephrotoxic agent.
Q: A patient in the intensive care unit is receiving gentamicin for treatment of pneumonia from
Pseudomonas aeruginosa. What assessment results should the nurse report to the health care
provider?
Answer:
Elevated creatinine level
*Gentamicin can be toxic to the kidneys and the auditory system. The elevated creatinine level
must be reported to the physician because it probably indicates renal damage. Other factors that
may occur with renal damage would include increased weight and decreased urinary output.
Many medications have side effects of anorexia.